Director of Testing and Quality Engineering – Health Plan Transformation

Position Overview

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

We are looking for a driven, experienced, and hands-on Director of Testing and Quality Engineering to lead testing for our HealthEdge implementation, a comprehensive healthcare SaaS platform designed to streamline operations, improve member experiences, and elevate care quality. The Director of Testing and Quality Engineering will drive the development of our test strategy, execution with our vendor partners, and build a testing center of excellence for the health plan. This role involves coordinating and leading multiple project teams, coordinating with senior leadership, and ensuring alignment with organizational goals and objectives. This is a matrixed management position with direct oversight of project resources.

Scope Of Role & Responsibilities

 Leadership & Strategy

• Develop and execute the enterprise testing and quality strategy across the health plan.
• Establish a governance framework for testing standards, quality metrics, and operational controls.
• Build and lead a testing team composed both of internal staff and vendor partners.
• Drive a culture of quality, transparency, and continuous improvement across the organization.
  
  
  

 Testing Oversight

• Oversee planning, execution, and validation of all testing cycles across core health plan platforms, including configuration, system, regression, integration, performance, UAT, and parallel testing.
• Ensure accuracy and reliability of benefit configuration, claims adjudication logic, enrollment processing, and provider data.
• Partner with both business and project organizations on overall release readiness, defect management, and issue prioritization.
• Develop a strategy and roadmap for test Implement test automation opportunities and modern QA practices to improve efficiency and speed-to-market.
  
  
  

 Quality Assurance & Compliance

• Monitor operational performance and quality metrics across health plan testing efforts.
• Drive root cause analysis and corrective actions for quality events, defects, and operational errors.
• Maintain documentation, controls, and quality processes.
  
  
  

 Cross-Functional Collaboration

• Collaborate with Operations, IT, Provider Network, Finance, and Compliance teams to ensure highquality delivery of new products, benefits, system releases, and regulatory changes.
• Provide quality oversight for vendor integrations and partner solutions.
• Lead quality governance forums and communicate testing outcomes, risks, and recommendations to program and executive leadership.
  
  
  

 Operational Excellence

• Implement dashboards, KPIs, and reporting to track quality performance and testing outcomes.
• Identify and execute process improvement opportunities to reduce defects and operational rework.
• Champion standardization across markets, functional areas, and product lines.
  
  
  

Required Education, Training & Professional Experience

 Bachelor’s degree in business, Health Administration, Computer Science, or related field.

 10 years of experience in health plan operations, systems testing, quality assurance, or related functions.

 Deep knowledge of health plan processes (claims, benefits, enrollment, provider data, authorization / utilization management).

 Experience with CMS guidelines, state health plan regulations, and accreditation standards.

 Demonstrated leadership experience managing high-performing teams.

 Strong expertise in QA methodologies, test management tools, and SDLC frameworks.

 Proven ability to manage large-scale, complex programs and multi-stakeholder initiatives.

 Familiarity with HealthRules, Facets, QNXT, or similar core admin platforms.

Professional Competencies

 Integrity and Trust.

 Customer Focus.

 Functional/Technical skills.

 Written/Oral Communication.

 Ability to work effectively in a fast-paced and dynamic environment.

 Strong analytical and problem-solving skills.

 Excellent leadership, communication, and interpersonal skills.